Association of angiotensin-converting enzyme gene polymorphism and clinical characteristics in Egyptian patients with major depressive disorder

Objectives Depression is one of the leading causes of disability and suicide worldwide. It has strong genetic etiopathogenesis, especially that related to angiotensin-converting enzyme (ACE) gene polymorphism. Therefore, this research tackled the relation between genetic variants of ACE polymorphism and symptomatology profile of major depression. Patients and methods A total of 42 patients diagnosed with depression matched with 39 controls underwent Structured Clinical Interview for the DSM-IV Axis I diagnosis clinician version, Structured Clinical Interview for the DSM-IV Axis I diagnosis-nonpatient edition, Hamilton Depression Rating Scale, real-time PCR for genotyping, and serum cortisol level assay. Results ACE I/D gene polymorphism was significantly higher in patients with major depression (45.2%) compared with the control group (25.6%). Patients with I/D polymorphism showed longer duration of illness; greater severity; higher number of episodes and rate of hospitalization; higher tendency to be prescribed serotonin/norepinephrine reuptake inhibitors and to receive electroconvulsive therapy; higher scores of core depressive symptoms, such as guilt feeling, inability to work, and suicidal ideation; and higher serum cortisol level than the other genotype groups. Conclusion Our findings support the notion that ACE I/D polymorphism affects major depression severity and symptomatology imprint.